Carbamazepine is a derivative of iminostilbene with carbamoyl group and related chemically to the tricyclic antidepressants. Carbamazepine has been introduced for treatment of trigeminal neuralgia. Recently it is used as an antiepileptic agent such as diphenylhydantoin. Antiepileptic drugs are known to affect experimentally induced cardiac arrhythmia and are now widely used clinically for treatment of ventricular tachyarrhythmias, particularly those produced by digitalis intoxication. Steiner et al. (1970) reported that carbamazepine was found to be very effective in converting ventricular tachycardia due to digitalis toxicity to normal sinus rhythm. Clinically bradycardia, complete heart block, ventricular standstill and Adams-stokes attack were reported in the course of carbamazepine treatment. The purpose of this study was to investigate the effects of carbamazepine on the ouabain-induced arrhythmia in vivo. The rabbits of either sex, weighing from 1.6 to 3.2 kg were anesthetized by urethane. After the trachea was cannulated, the rabbits were ventilated with room air using a respirator. Drugs were given into polyethylene cannula in the femoral vein. Blood pressure were recorded by physiograph via pressure tranducer connected with the cannula in the femoral artery. EKG were recorded by physiograph via electrode implanted in both fore leg and left hind leg. The results are summarized as follows 1. Arrhythmia was induced by continuous infusion of ouabain (65±8.8 µg/kg). 2. Single administration of ouabain (64 µg/kg) induced arrhythmia which was persisted for 7-8 min. 3. Ouabain induced arrhythmia was restored to normal sinus rhythm by administration of carbamazepine (the more dosage, the less frequent and the longer duration). 4. Severe bradycardia, A-V block, atrial fibrillation were seen on the EKG after injection of carbamzepine alone. By the above results, it may be concluded that carbamzepine inhibits the ouabain-induced arrhythmia by dose-dependent.
Anticonvulsants ; Antidepressive Agents, Tricyclic ; Arrhythmias, Cardiac* ; Atrial Fibrillation ; Blood Pressure ; Bradycardia ; Carbamazepine* ; Catheters ; Digitalis ; Electrocardiography ; Electrodes ; Femoral Artery ; Femoral Vein ; Heart Block ; Leg ; Ouabain ; Phenytoin ; Polyethylene ; Rabbits* ; Tachycardia ; Tachycardia, Ventricular ; Trachea ; Trigeminal Neuralgia ; Urethane ; Ventilators, Mechanical

Purpose: To evaluate outcomes and complications after traumatic posterior hip fractures and dislocations classified according to the Thompson-Epstein system. Materials and Methods: Thirty-five cases were selected from among the patients we treated between January 2000 and December 2005. According to Thompson-Epstein classification, 5 cases were type I, 7 cases were type II, 5 cases were type III, 8 cases were type IV, and 10 cases were type V. The mean age at the time of injury was 41 years (range: 19~72 years). Twenty-six patients were men, and 9 patients were women. The mechanisms of injury included traffic accidents in 30 cases and falls in 5 cases. The mean follow-up period was 31 months (range: 13~86 months). Fracture reduction was achieved within 6 hours in 32 cases. Thirty-four patients underwent closed reduction, and 22 of these patients were treated using Allis'method. Results: All Thompson-Epstein type I fractures were managed with closed reduction. Two type II fractures were treated conservatively, and 4 were treated with open reduction and internal fixation. All 13 type III and IV fractures were treated using open reduction and internal fixation. Six type V fractures were treated conservatively, 4 were treated with open reduction and internal fixation, and 1 was treated using total hip arthroplasty. Posttraumatic arthritis was observed in 9 cases, 7 of which were Thompson-Epstein type IV. Avascular necrosis (AVN) of the femoral head and deep vein thrombosis were observed in 1 case. Sciatic nerve injury was seen in 5 cases. Conclusion: Complications often occur in Thompson-Epstein type IV fractures. We believe that early, appropriate anatomical reduction helps to improve outcomes.
Arthritis ; Arthroplasty ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Hip Fractures ; Humans ; Male ; Necrosis ; Sciatic Nerve ; Venous Thrombosis

Since 1976, 938 cases of E.R.C.P. were performed at the Kwangju Christian Hospital & since December 1981, 19 cases of Endoscopic papillotomy(E.P.T.) were performed, following Results were obtained: 1) Out of 19 cases which were diagnosed by E.R.C.P.; 17 cases of C.B.D. stones, 1 case of ascaris in bile duct, 1 case of remained C.B.D. stone diagnosed by T-tube cholangiogram after operation, & E.P.T. was done in total 19 casees. 2) During 1st E.P.T., 2 cases were removed by Dormia basket under direct visualization & during 2nd E.P.T., 5 cases were removed by Dormia basket under direct visulization & 12 cases were passed in stool & 3x3.5cm large stone passage was found. 3) Complications of E.P.T. were noted in 2 cases: 1 case of bleeding was treated by blood transfusion & 1 case of Acute pancreatitis was treated by medical care.
Ascaris ; Bile Ducts ; Blood Transfusion ; Common Bile Duct* ; Gwangju ; Hemorrhage ; Pancreatitis ; Sphincterotomy, Endoscopic*

PUEPOSE: To evaluate the treatment results and complication of a femoral head fracture with posterior dislocation of the hip according to the Pipkin classification. MATERIALS AND METHODS: Ten cases of Thompson-Epstein type V femoral head fracture with a posterior dislocation of the hip were evaluated. According to the Pipkin classification, 5 cases were type I, 1 case was type III, and 4 cases were type IV. The average age at time of trauma was 38 (19~72) years, and the causes were traffic accidents in 9 cases and falls in 1 case. The average follow-up period was 33 (13~79) months. A reduction of the fracture was performed within 6 hours in 9 cases and 12 hours in 1 case. When the stability was achieved after the reduction, the choice of further treatment was made from either conservative treatment while maintaining skeletal traction, or surgical treatment according to the fracture type and instability. The complications were evaluated by a physical examination, simple radiography, computed tomography (CT) and magnetic resonance imaging (MRI). RESULTS: In Pipkin type I fractures, 4 cases were treated with conservative treatment and 1 case was treated with surgical treatment. One case of Pipkin type III fracture was treated with primary total hip arthroplasty. In Pipkin type IV fractures, 2 cases were treated surgically using a plate and 2 cases were treated with conservative treatment with skeletal traction. Bone union was achieved in all cases. One case of mild posttraumatic arthritis and 1 case of avascular necrosis was found, respectively in Pipkin type IV. CONCLUSION: The extent of the initial injury has an effect on the prognosis of a hip fracture and dislocation.
Accidents, Traffic ; Arthritis ; Arthroplasty, Replacement, Hip ; Classification ; Dislocations* ; Follow-Up Studies ; Head* ; Hip* ; Magnetic Resonance Imaging ; Necrosis ; Physical Examination ; Prognosis ; Radiography ; Traction

PURPOSE: High false negative results on fine needle aspiration cytology (FNAC) have been reported in the diagnosis of breast cancers, which are small sized, desmoplastic type, infiltrating lobular cancers, tubular cancers, and mucinous cancer. METHODS: From Jan. 1997 to Dec. 1998, we performed 622 FNACs at the Department of Surgery, Korea University Hospital. Among those aspirates, 246 cases were followed by subsequent pathological confirmation and were included in this study. Pathological reports for breast specimens were reviewed for the size, the location, the grade or the pathological subtype, and the presence of fibrosis in the breast lesions. The pathological characteristics were compared statistically with the results of the fine needle aspiration cytology. RESULTS: The likelihood ratios for malignant, suspicious, atypical, benign, and unsatisfactory cytological diagnoses were 98.7, 5.5, 1.1, 0.07, and 0.6, respectively. The absolute and the complete sensitivities for the malignant lesions were 64.5% and 90.3%, respectively. The rate of unsatisfactory diagnosis was 9.3%, and the false-negative rate was 4.3%. The concordance rates of FNAC results were 75% for tumors less than 1 cm in size, 60.7% for 1-2 cm, 76.5% for 2-5 cm, and 50% for greater than 5 cm (p=0.01). The location of the tumor also affected the FNAC result, and the highest concordant rate was found in tumors of the lower outer quadrant of the breast (73.3%, p=0.001). The Bloom-Richardson grade and histologic type of the breast cancer also affected the FNAC result. Low-grade tumors, medullary carcinomas, metaplastic carcinomas, lobular carcinomas, adenoid cystic carcinomas, and mucinous carcinomas usually showed discordant FNAC results. The presence or the absence of fibrotic pathology did not affect the FNAC result (p=0.39). CONCLUSION: The sensitivity of FNAC was 90.3% in the diagnosis of breast cancer and the false negative rate was 4.3%. The greatest concordance of FNAC diagnosis was found in the patients with tumor less than 5 cm in size and located in the axilla and locoregional recurrent area. The FNAC results for breast cancer were frequently incorrect for low-grade tumors and cancers of a rare pathological type.
Adenocarcinoma, Mucinous ; Axilla ; Biopsy, Fine-Needle* ; Brain Stem Neoplasms ; Breast Neoplasms* ; Breast* ; Carcinoma, Adenoid Cystic ; Carcinoma, Lobular ; Diagnosis* ; Fibrosis ; Humans ; Korea ; Mucins ; Pathology

PURPOSE: The purpose of this study is to analyze the results of intertrochanteric fractures treatment with proximal femoral nail antirotation (PFNA) without using fracture tables and thereby prevent complications. MATERIALS AND METHODS: Forty cases of intertrochanteric fracture of 39 patients that were treated with PFNA without using fracture tables between January 2008 to December 2009 were analyzed. There were 13 males and 27 females. The mean age was 76 years old. Using AO classification, 6 cases were A1, 25 cases were A2 and 9 cases were A3. The operation was done without using fracture tables at supine position. Operation time, intraoperative bleeding were checked. For the result, Cleveland index, tip apex distance, fracture site sliding rate, change of femur neck and shaft angle were evaluated. Bone union time and complications were also estimated from the follow up radiograph. Statistics were analyzed using Independent T-test. RESULTS: The mean operation time was 40 minutes (25 to 70 minutes) and mean intraoperative bleeding was 113 cc (40 to 250 cc). The Cleveland index was shown 94% of 5, 6, 8 and 9 zone, the tip apex distance was 12.96 mm (6 to 22 mm), the fracture sliding distance was 1.9 mm (0 to 6 mm), the change of femur neck and shaft angle was 2.5 degree (0~10 degree) and the average bone union time was 15 weeks (8 to 24 weeks). The complication include 2 cases of delayed union and 2 cases of varus deformities. CONCLUSION: We have shortened the operation time by closed reduction methods without using the fracture tables, and the complication were minimized with using simple tools like a reduction forcep or bone hook at PFNA blade insertion.
Female ; Femur ; Femur Neck ; Follow-Up Studies ; Hemorrhage ; Hip Fractures ; Humans ; Male ; Nails ; Supine Position ; Surgical Instruments

BACKGROUND AND OBJECTIVE: Buckwheat is considered one of the most important food allergens in Korea. Although a very small amount is ingested or inhaled, it can cause serious allergic reactions. However, the major allergens of buckwheat still remain to be elucidated. The aim of our study was to identify and characterize the major allergen of buckwheat seed. MATERIAL AND METHOD: Dialysis membrane with a cut-off MW 1kD was used for the preparation of crude buckwheat seed allergen extract. SDS-PAGE under reducing conditions and IgE immunoblotting were performed using sera from 15 buckwheat sensitive subjects. Isoelectric focusing and lectin blotting assay were done. RESULT: Western blot analysis showed more than 15 IgE-reactive buckwheat proteins. Among them, a 24kD protein was shown to be the most frequently bound to sera from allergic subjects (54%). Isoelectric point of 24kD protein was around 5.9. In lectin blotting assay, 24kD protein did not bind to Con A nor five other lectins. CONCLUSION: A 24kD protein was the most frequently recognized allergenic component in buckwheat seed. Isoelectric point was around 5.9. Glycosylation was not detected in 24kD of buckwheat protein.
Allergens ; Blotting, Western ; Dialysis ; Electrophoresis, Polyacrylamide Gel ; Fagopyrum* ; Glycosylation ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Isoelectric Focusing ; Isoelectric Point ; Korea ; Lectins ; Membranes

Schinzel-Giedion syndrome is a rare, distinct dysmorphic syndrome characterized by congenital hydronephrosis, skeletal dysplasia, and severe developmental retardation, likely to be inherited as an autosomal recessive trait, but not yet confirmed. This syndrome is characterized by coarse facial features such as midfacial retraction, bulging forehead, short nose with anteverted nostrils, low-set malformed ears, protruding large tongue, and hypertelorism. Skeletal and limb defects, choanal stenosis, simian creases, hypospadias, microphallus, hypertrichosis, and intractable seizures are the frequently associated clinical findings. Urogenital involvement is a major component of the syndrome, and this problem sometimes is associated with nephrocalcinosis and urinary tract infection in the clinical course of the disease. We report a 22 month-old girl with Schinzel-Giedion syndrome complicated by medullary nephrocalcinosis and urinary tract infection due to Klebsiella pneumoniae. This patient had also been suffering from postnatal growth deficiency, intractable seizure, spastic tetraplegia, delayed development and severe mental retardation.
Constriction, Pathologic ; Ear ; Extremities ; Female ; Forehead ; Humans ; Hydronephrosis ; Hypertelorism ; Hypertrichosis ; Hypospadias ; Infant ; Intellectual Disability ; Klebsiella pneumoniae ; Male ; Nephrocalcinosis ; Nose ; Quadriplegia ; Seizures ; Tongue ; Urinary Tract Infections

PURPOSE: Long-term prognosis of Henoch-Schonlein purpura(HSP) is determined by the existence and severity of renal involvement. We evaluated the relationship between various clinical features of HSP and the development of renal involvement using univariate and multivariate analyses for early detection and proper management of HSP nephritis. METHODS: We performed a retrospective study of 200 children who were diagnosed as HSP and were initially free from renal involvement, from 1998-2003. Clinical features of each patient as risk factors of renal involvement were evaluated by univariate and multivariate analysis. Significant risk factors proven by univariate analysis were paired and re-analyzed to see if there are any interactions between them. RESULTS: A univariate analysis showed that sex, previous disease, severe abdominal symptoms, persistent purpura and steroid administration were associated with developing renal involvement. Among them, severe abdominal symptoms, persistent purpura, and male sex were statistically significant when they were re-analyzed after pairing, and they also increased the risk of renal involvement in a multivariate analysis. CONCLUSION: Severe abdominal symptoms, persistent purpura, and male sex are independent risk factors of renal involvement in HSP and it is presumed that interaction between them could be another factor of HSP nephritis.
Abdominal Pain ; Child ; Humans ; Male ; Multivariate Analysis* ; Nephritis ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch* ; Retrospective Studies ; Risk Factors*